Among high-risk, long-term nursing home patients, pressure ulcers are more prevalent in black residents than in white residents, according to a Medscape Medical Newsarticle based on a study published this month in JAMA.

In the past decade, nursing homes have instituted quality-improvement programs, but it is unclear what effect they might have had on racial disparities. Previous studies have shown that black residents of nursing homes are at a higher risk for pressure ulcers, but a higher proportion of black nursing home residents reside in facilities with limited clinical and financial resources, which may explain the discrepancy, says Medscape.

To determine what effect quality-improvement efforts have had on racial disparities, the researchers conducted a longitudinal study of pressure ulcer prevalence in high-risk, long-term nursing home residents. The study included 12,473 certified nursing homes in the United States, with 2.1 million white residents and 346,808 black residents. The nursing homes included in the trial used the nursing home resident assessment, online survey, certification and reporting files, and area resource files from 2003 through 2008. The researchers categorized the nursing homes by the relative proportions of black residents.

Between 2003 and 2008, the researchers found an overall decrease in pressure ulcer rates. Despite this improvement, black residents had higher pressure ulcer prevalence than white residents. In 2003, black residents had a rate of 16.8% compared with 11.4% for white residents. In 2008, black residents had a prevalence of 14.6%, whereas white residents had a prevalence of 9.6%.

Among nursing homes with more black residents (35% or more of residents), there were higher rates of ulcers among both black residents and white residents in comparison with nursing homes having less than 5% black residents. Nursing homes with higher proportions of black residents typically had fewer registered nurses and certified nurse assistants and were more likely to be large, for-profit, and urban, the article says.

Comments

Please consider that there is an extraorinarily high error in diagnosing Stage I ulcers in patients with darkly pigmented skin. These individuals DONT turn RED. This was well documented and researched in the 1980's and 90's. I am not aware that this knowledge ever was included in our Guide To Practice nor in our wound textbooks. Carrie Susman and I were the only two PT's on the national task force. Her textbook includes the full discussion !!! Please use this opportunity to ignite new interest in publishing the evidence and best practice guidlines ! Thank you for asking!
made

Posted by Lynda Woodruff
on 7/30/2011 8:36 PM

QUESTION: WAS THE RESIDENT(S) ADMITTED TO A SNF WITH THE PRESSURE ULCER OR WAS IT ACQUIRE IN THE SNF?
OFTEN HOSPITALS MISS STAGE 1 (ESPICALLY IN DARK SKIN PERSONS). THEN THE SNF IS LEFT TO HEAL IT.